Infectious complications in the management of systemic vasculitis and rapidly progressive glomerulonephritis.
Patients with microscopic polyarteritis and Wegener's granulomatosis are often elderly. At present 10-20% of these patients will die from infection in the first three months of immunosuppressive treatment. Therapeutic strategies initially must maximize anti-inflammatory and immunosuppressive effects and minimize the later in the longer term. Regimens with pulse MP combined with low dose prednisolone (ie 20 mg/day), together with oral or pulsed cyclophosphamide in the first weeks followed by maintenance treatment with azathioprine and prednisolone are suggested--with PE reserved for those requiring dialysis, lung haemorrhage, or uncontrolled vasculitis.
Neild
G H
GH
Dept. of Renal Medicine, Institute of Urology, UCMSM, St Philip's Hospital, London, U.K.
D003141:Communicable Diseases / Q000209:etiology*; D005921:Glomerulonephritis / Q000150:complications*; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy
D007166:Immunosuppressive Agents